An unnamed 16-year old in the Dominican Republic has died from leukaemia complications. The “complications” were as a result of a “dilemma”: the girl was pregnant and chemotherapy, which she needed, would kill the foetus. Under Article 37 of the Constitution, it states “the right to life is inviolable from the moment of conception and until death”. This is “interpreted quite straightforwardly in courts” and “as a strict mandate against abortion”. Her situation came to light because she had to wait some twenty-days while the issue was fought over. It’s uncertain whether the delay itself killed her, but hardly any one, I think, can dispute it certainly made things worse.
The case of an anorexic woman also received frequent media coverage. As Jacob Williamson summarises it, in his series of posts on the case: “a woman has suffered from anorexia to such an extent that the only way she stands any chance of surviving is to be force fed in hospital for a year. She does not consent to this option, but if it does not go ahead then she will certainly die. The judge ruled that she is to be force fed.” Her own reasons and autonomy are being disregarded. The ethics of this case are complicated, but the automatic assumption that she should be force-fed to continue living is our main focus.
Tony Nicklinson, after being denied the right to kill himself (with assistance), has also recently died. Six days after losing the case, and after refusing food, he went rapidly downhill after contracting pneumonia. Nicklinson’s fight was for the assurance that there would be no prosecution for anyone who helped him die – given his locked-in state. Unlike many cases dealing with euthanasia, Mr Nicklinson was “not terminal” – a term that is still debated – but he did feel his life was not worth living. As he said after the verdict: “I am saddened that the law wants to condemn me to a life of increasing indignity and misery."
Both of these cases indicate and emerge from the idea that life is sacred. This is the property where a phenomenon must be protected, revered and so on, at all costs. Sanctity emerges from a connection with some transcendent realm, but in terms of the broad, nebulous term of the ‘sanctity-of-life’, it is almost entirely theistic. Indeed, "life" is not all life - from bacteria to Bono - but the category of human life. Catholic theology tends to have the heaviest focus. As Aquinas terms it, sanctity contains two properties: firmness and cleanliness. By ‘cleanliness’ he meant that it is not part of the ‘profane’ world, of mortals and muck. We remove shoes before entering sacred temples, cleanse ourselves with special rituals, and so on [cleanliness and godliness and all that]. By ‘firmness’, he meant that this property could/should not be removed. It was a crime against god to do so. Thus, sanctity is, according to the Catholic Encyclopaedia: “a quality of an object that is withdrawn from the profane and consecrated to God”.
Human life then, if considered sacred, is to be revered, treated with the utmost respect, never impeded, always promoted and so on. This is not entirely - though it is mostly - a bad concept. The main problems are that it is too excessive and targets the wrong aspect of human existence.
Of Quality and Quantity
What matters to our existence is, I would think, not the length of our life but its value. In other words, it is the quality of our life, not the quantity of it. Surely most would rather want a content, pain-free short life above one that is long but filled with constant boredom and pain? However, this isn’t about appealing to majority: The point isn’t to say that no one is allowed to continue living with boredom and pain. That is their choice. But this works both ways: if you do not wish to, you can opt for that, too.
Secondly, there is little wrong with defending and trying to extend life. This is a good thing on a basic, broad level. This is indeed one aspect of medicine. I say one because, as I indicated in the previous paragraph, one aspect of what matters to our lives concerns reducing and avoiding unnecessary suffering. Few doctors I know would say they would want to keep a brain-dead patient alive, while he simply drains resources that could be spent on those patients who are actually aware and alive and need those resources now; few would say we should never turn off respirators.
There are places to defend human life, but again: what we’re defending primarily is to extend the good life, not the suffering one. What I want to propose is the following: Life should be considered a neutral term in moral discussions - we are trying to work out what kind of life it is.
Promoting Good Life
Sanctity does little to help us in terms of promoting a good life. It is primarily aimed at promoting more life. Yet, if that life is filled with suffering or pain, why would anyone want more of it?
Indeed, as highlighted by the cases at the beginning, the defence of sanctity leads to unnecessary suffering and, indeed, (painful) dying. Why should human life be revered so excessively just because it’s human? Humans have different experiences of that life; to ignore the spectrum of human experience for the assertion of monochrome existence is to treat moral thinking in black-and-white terms. This leads to bad moral judgements, since the world is more complicated than binary ethical frameworks constituting of (absolute) right and wrong can allow for. If we're not engaging with reality properly, we can't do a good job of fixing what's wrong (or even identifying properly what is wrong).
What we should be saving, what we should be promoting, are good lives. Lives that the people themselves tell us they want. Even if it is the case that someone isn’t suffering any kind of biological disability, this still gives us no automatic reason to oppose her: if she wishes to end her healthy life, that remains her choice. We are not the ones experiencing her life; we have no right to drag her experience out just because we want to promote the nebulous but broad concept of human life. (This doesn't mean we just let people do what they want, even to their own lives and bodies, though.)
As soon as we stop respecting people’s interpretation of their own lives, we start arrogating mastery over their existence. A prime aspect of totalitarianism is omniscience and any entity which defends it should warrant our suspicion: thus people who claim to, for example, know Tony Nickilinson’s life was better off being extended, are worthy of being distrusted with the same vehemence as any defender of authoritarianism. This doesn’t mean we lock them up or treat them unjustly: it means we must keep our guard up against this metatron of superhuman abilities. These people are mistaken but are also dangerous in their thinking. One day, you or someone you love could be in such a position where life is not worth living anymore. And such voices of omniscience will assert that life is better lived longer, that to shorten it is immoral, because life just is sacred.
They are mistaken but its the ubiquity of this view that is its most dangerous aspect. More is needed, voices must speak and argue louder, so we can overturn the assumption, embedded so deeply in many places in society, that life is better because it is longer, as opposed to life is better because we can make it so.
UPDATE: Apparently the doctors are disputing the claim that girl from Dominican Republic died because of the law. The "anti-abortion laws had nothing to do with [the delay]. Rather, doctors from the Semma Hospital in Santo Domingo maintained that 'because they were waiting for her bone marrow test results to come back from a hospital in New Jersey to determine what kind of leukemia she had.'" [Source: ABC News]. However, the following paragraph disputes it. The point remains that such a law exists at all. Thanks to readers for pointing this out.
Image Credit: Oluf Olufsen Bagge/WikiCommons (source)